GEOGRAPHIC, AGE, AND RACIAL VARIATION IN THE TREATMENT OF LOCAL REGIONAL CARCINOMA OF THE PROSTATE/

Purpose: Prostate cancer is one of the most common cancers in men. Inc idence rates increase with age and are substantially higher in black m en than white men. This study examines the variations in the use of ra dical prostatectomy and radiation by geographic area, age, and race. M aterials and Methods: Data from the National Cancer Institute's Survei llance, Epidemiology, and End-Results Program (SEER) were used to exam ine treatment differences. Current treatments generally consist of pro statectomy, radiation, or careful observation for clinically localized or regional disease. Results: The age-adjusted proportion of men, age 50 and older, who received radical prostatectomy increased sharply be tween 1984 and 1991, from 11.0% to 32.3% among men with local/regional disease. The choice of treatment varied widely by geographic regions. In 1991, the proportion that received prostatectomy was highest in Ut ah (47.8%) end lowest in Connecticut (22.5%) among men with localized and regional disease. The increase in radical prostatectomy was not li mited to younger men. Although the rates increased for blacks, black m en had lower age-adjusted rates of prostatectomy than whites in all ye ars of the study. Conclusion: The SEER data show a clear trend toward more aggressive treatment, especially prostatectomy. However, the prop ortion of black men who received prostatectomy was substantially lower than that of white men and this disparity does not appear to be chang ing.